Surgical and wound dressings which absorb bodily exudates and maintain fluids and topical medication at the skin surface for use in the treatment of burn patients are generally well known in the medical arts. Sterile dressings of this type maintain an incision free of lint or other contaminants which can lead to the complication of granulomas. Additionally, non-adherence to a wound or incision is necessary in order to minimize pain associated with the removal and replacement of the dressings, as well as minimize wound trauma and its associated risks of infection and delayed healing.
By way of example, the treatment of burns involves a periodic exuding of bodily liquids such as lymph and blood. In order to treat such symptoms, it is necessary to employ a bandage which is non-adherent and highly absorbent to effect dispersion of bodily discharges. Such dressings must also have the capacity to absorb fluids and medicaments in order to guard against infection and dehydration of the patient.
Another application for wound dressings is the care of surgery patients. One specific example of such surgery is radical mastectomy. This type of surgery, which can affect either or both the right and left side of a woman's chest can be particularly problematic because of the significant discharges of exudates and the need to maintain the dressing at its optimum functional capacities. It is also necessary, with dressings for the upper torso of the body, for medical personnel to be able to frequently examine the wound with minimum discomfort to the patient and, of course, with minimum damage to the sensitive wound tissue itself. Since radical mastectomy frequently also involves removal of lymphatic glands in the axilla or the region underneath the arm, that region, as well, must be properly drained and guarded. Typically, gauze, in the form rolls, stretch wraps, sponges and vests, as well as ABD pads have been used. However, these aforementioned products have similar problems. These dressings stick to the wound and cause extreme or severe discomfort to the patient during dressing changes. These dressings also destroy new tissue being formed while leading to friction and shearing of new tissue. This allows maceration of the wound. Dressing and dressing changes are also time consuming due to the need to (a) unwrap multiple layers of dressing material; and (b) re-wrap new multiple layers of dressing material.
Lack of wicking action, which does not allow absorption by an entire dressing area, leads to "strike-through". This occurs when drainage is concentrated to the area equal to the size of the wound. Drainage has nowhere else to go but "out" the back side of the dressing. When strike-through occurs the following results: there is poor utilization of dressing material area which is costly. Also, one cannot re-use the dressing material and, therefore, more frequent dressing changes, are required which cause repeated pain and discomfort to the patient and take additional nursing time. Additionally, this does not allow the patient to heal properly and the patient soils garments and beddings which leads to additional costs for cleaning and/or replacement. Because healing is retarded, additional tissue is destroyed and leads to dead tissue odors which can be embarrassing to patients and unpleasant to staff. Use of excessive layers of dressing materials to try and absorb as much exudate as possible, as suggested, is time wasteful, consumes excessive material and increases costs. If too much material is used the dressing becomes too bulky and this may, in turn, limit the patient's mobility or limit the free range of motion and make the dressing extremely uncomfortable to the patient.
Medical staff cannot evaluate wounds without at least partially removing dressings. This, as indicated, causes pain and discomfort to the patient, destroys new tissue and is time consuming. The known approaches require additional materials (i.e. tape) to secure the dressing materials in place. Using tape leads to tape burns, sensitivity due to allergies to tape substrates and adhesives. Skin tears upon removal is common. When wounds cover large areas unavailability of healthy skin to which tape can be applied leads to poor conformance to the wound which is necessary for good wound healing.
Attempts to overcome the problems associated with common wound dressings have been made by the use of various "body" dressings. Such body dressings are typically formed in the shapes of the body surfaces for which they are intended to cover and protect. Such body dressings which have been sold by Exu-Dry Wound Care Products, Inc., of the Bronx, New York, are specifically shaped to conform to the shapes of the head, arms/hand and leg/foot. Additionally, Exu-Dry also distributes torso dressings which are intended to cover the chest, abdomen and buttocks. All these body dressings have been made of non-occlusive materials. However, the torso dressings which have been sold by Exu-Dry are formed of front and rear panels which are permanently attached above the shoulder. The rear lateral sides of the panel wrap around the sides of the patient and are secured to each other both by means of hook and loop tape fasteners as well as string ties. While this construction has proven adequate for covering and conveniently examining the lower portions of the torso, they have not been practical in so far as the upper torso and the axilla or underarm areas are concerned. To examine and treat those areas, it has been necessary to separate the rear panel extensions from the front panel and lift the front panel almost totally over the head of the patient. Even under those conditions, access to the axilla and upper torso, including the shoulders, has been impractical and uncomfortable to the patient.